Mayday Health Helps Patients Get Abortion Pills In States With Bans

dr. Jennifer Lincoln has amassed nearly 3 million followers on TikTok through her candid, educational videos about sex, abortion, and reproductive care. And soon, she told TIME, the Oregon-based OB-GYN will take on a new role as Executive Director of Mayday Health, a health-education nonprofit founded in the wake of Dobbs v. Jackson Women’s Health to help patients in states that have banned abortion figure out how to get abortions anyway.

“Education is the great equalizer,” Lincoln says in a phone call during a break on her labor and delivery shift. “When you know this, you know how you protect yourself, and that’s true reproductive freedom.”

Lincoln and Mayday are on the front lines of the next battle over abortion rights: the information war. Mayday launched on the day the Supreme Court overturned Rowe v. wade with the simple goal of spreading the word about abortion pills—two medications prescribed by a doctor that, when taken within 48 hours of one another during the first trimester, can safely terminate a pregnancy. For patients living in states where abortion is banned, Mayday lays out the step-by-step process for how to obtain the pills, through mail-forwarding or ordering from abroad, and provides medical information about the safety and reliability of medication abortion in the first trimester of pregnancy.

“The most valuable message anyone can spread is telling the folks who live in those states how they can still make decisions about their own bodies,” says Sam Koppelman, a Democratic speechwriter and co-founder of Mayday. “It’s fundamentally an information battle.”

Read More: Republican States Crack Down on Access to Abortion Pills.

Many abortion opponents have shifted their focus from shutting down abortion clinics to trying to shut down accessible information about reproductive health. A bill proposed in South Carolina would make it illegal to “aid, abet, or conspire with someone to procure an abortion,” or “advertise the sale or distribution of an abortifacient.” That bill closely mirrors a National Right to Life Committee blueprint mapping out an “effective enforcement regime” to eliminate abortions, which recommends outlawing “giving instructions over the telephone, the internet, or any other medium” or “hosting or maintaining a website, or providing internet service, that encourages or facilitates” efforts to obtain illegal abortions.

Even if these laws fail to pass or are successfully challenged in court, the wave of new abortion restrictions has curtailed sources of reliable information about reproductive health. Doctors across the country are caught in legal limbo about how to advise patients who need abortions. Library workers in Oklahoma were told they could face a $10,000 fine for helping patrons find information about abortion. The University of Idaho blocked staff from referring students to abortion providers or emergency contraceptives. In Nebraska, a woman is being prosecuted after police obtained a private Facebook message in which the mother advised her daughter on how to take abortion pills.

Read More: Inside Mississippi’s Last Abortion Clinic.

So while other reproductive-rights groups concentrate on litigation, electoral organizing, or funding travel for abortions, Mayday is focused on delivering information that women in many states can no longer reliably get from their doctors. Two weeks after the last abortion clinic in Mississippi closed, Mayday put up three billboards in Jackson saying “Pregnant? You Still Have a Choice” with a link to their website; after the Attorney General sent them a subpoena asking them to remove the billboards, Mayday added 20 more across the state. When Idaho’s flagship university blocked staff from discussing abortion or emergency contraception, Mayday responded by driving a digital billboard through campus—”They don’t want you to know this: You can still get abortion pills by mail,” it read—and parking it outside the football stadium on a Saturday night.

The 501(c)(3) organization has partnered with social-media influencers like Dr. Lincoln and released ads on Pandora targeting core demographics who might need abortions. It’s particularly focused on low- to middle-income women between the ages of 18 and 44 who live in states that heavily restrict abortion. Koppelman says that the goal is to reach patients at the moment when they’re searching for their options. In states with abortion bans, “if you search ‘how to get abortion pills,’ or ‘I need to get an abortion’ or ‘I need to end a pregnancy,’ Mayday comes up at the top of the search results,” he says.

Abortion pills are nothing new. More than 50% of all abortions in the US in 2020 were medication abortions, according to the Guttmacher Institute. But since Rowe was reversed, requests for abortion pills have surged: a study published in the medical journal JAMA found that requests for abortion pills from international telemedicine organization Aid Access jumped from 83 per day before the dobbs decision to an average of nearly 214 requests per day, with much of the demand coming from states with abortion bans.

In 2021, the FDA permanently changed a regulation requiring mifepristone to be obtained in person, which means that both pills that produce a medication abortion—mifepristone and misoprostol—can now be sent through the mail. And yet, particularly in states where abortion clinics have shut down and crisis-pregnancy centers spread false information about abortion, many patients don’t know that the pills are safe, or how to get them.

Read More: Anti-Abortion Pregnancy Centers Are Collecting Troves of Data That Could Be Weaponized Against Women.

“We kept hearing from groups, activists, advocates that abortion pills were going to be the future in a post-Roe era, but that very few people knew about them,” says Olivia Raisner, a Democratic digital strategist who co-founded Mayday with Koppelman and Nathaniel Horwitz. “A lot of groups couldn’t take on the risk of spreading the word.”

Even though the pills themselves may now be illegal in some states, those state laws cannot prohibit an out-of-state group from providing general information about them. The founders of Mayday say they are confident that their messaging is protected speech under the First Amendment. The organization doesn’t prescribe, provide, or even handle abortion pills, Raisner says, which means they can’t be accused of advertising or selling them.

But while Mayday argues their digital advertising and billboards are constitutionally protected, some legal scholars caution that conservative judges might not agree. “They should be protected by the First Amendment, but am I really confident that the current Supreme Court agrees with me? No, not really,” says Mary Ziegler, a professor at UC-Davis School of Law, who writes about the politics of abortion. “I think the law on where ‘aiding and abetting’ begins and where constitutional protections kick in can be a little unclear.”

The fact that Mayday does not sell or manufacture abortion pills themselves provides some legal cover, says Geoffrey Stone, a professor at the University of Chicago Law School who has written several books about freedom of speech. “If all they’re doing is informing people how they can obtain the pills but not actually selling them, then it’s not commercial advertising and would be more likely to be protected,” says Stone.

For Mayday, spreading the word about the safety and efficacy of abortion pills is the best way to ensure that patients can access abortion even in states where it is now illegal. “We know that these restrictive laws are not going to decrease abortion. They’re just going to make them unsafe and more dangerous,” says Dr. Lincoln. “We can tell people nothing, or we can use free speech to point people toward resources that do exist, and people can decide what they want to do for themselves.”

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write to Charlotte Alter at charlotte.alter@time.com.

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